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Appealing workers' compensation claim rejection

Should your workers' compensation claim be denied, you have options for appealing this decision. Those seeking a review of claims in Iowa file with the Iowa workers' compensation commissioner. The duration of the appeals process can depend on the type of injury sustained and the benefits associated with compensation policy.

While the appeals process is long and winding, here are steps that are typically followed to remedy the situation:

1. Filing for appeal

In order to begin the appeals process, you will need to present certain documentation. Upon submitting the contested case petition with the Iowa worker's compensation commissioner, you will signal your intent to appeal the denial. Paperwork will also need to be sent to the insurance company. When the proper documentation is on file, you can schedule a hearing.

2. Informal hearing

Previous to engaging in a formal hearing, the two parties can participate in an informal hearing. It is here that a mediator strives to establish a voluntary agreement between parties. Should a satisfactory resolution fail to materialize, formal hearings are scheduled.

3. Administrative hearing

A deputy workers' compensation commissioner will preside over the case. During the course of the hearing, each side presents evidence regarding the claim rejection. Your testimony and testimonies by expert witnesses will be recorded at this time. Reviewing evidence presented, the arbitrator will render a decision that will be delivered through mailed correspondence.

4. Appeal of decision

Should you remain unsatisfied with the ruling, you may contact the commissioner with a filed notice of appeal. Although the commissioner will not usually convene another hearing, the decision will be made after a review of evidence provided in the initial administrative hearing.

5. Moving appeals to the Iowa court system

If the commissioner's decision does not provide a pleasing resolution, you have three more venues in which your case can be heard: Iowa district court, the Iowa Court of Appeals and the Iowa Supreme Court. Your appeal will need to be filed within the time period provided in the commissioner's decision.

While the appeals process does allow individuals to receive benefits owed to them, the steps required to conduct a successful appeal are complicated. For this reason, individuals seeking workers' compensation are advised to seek the guidance of a knowledgeable attorney.

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